RANDALL W CHANG Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000368

License Status

NOT RENEWED

Business

First Name

RANDALL W

Last Name

CHANG

Business Name

RANDALL W CHANG

Original Issue Date

09/19/1988

Effective Date

09/19/1988

Expiration Date

03/01/1990

City

CHAMPAIGN

State

Zip

61821

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

09/26/2006